mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-PFO-2634mimmun-2634Research ArticleОБЗОРЫREVIEWSПатофизиологические особенности хронических IgЕ-опосредованных риносинуситов бактериальной этиологииPathophysiological features of chronic IgE-mediated rhinosinusitis of bacterial etiologyСмирноваО. В.SmirnovaO. V.

Д.м.н., профессор, заведующая лабораторией клинической патофизиологии

Адрес для переписки:Смирнова Ольга Валентиновна –Научно-исследовательский институт медицинских проблем Севера660022, Россия, г. Красноярск, ул. Партизана Железняка, 3г. Тел.: 8 (913) 567-97-19.

PhD, MD (Medicine), Professor, Head, Laboratory of Clinical Pathophysiology

Address for correspondence:Olga V. Smirnova - Research Institute of Medical Problems of the Northб3g Partizan Zheleznyak StKrasnoyarsk660022 Russian FederationPhone: +7 (913) 567-97-19.

ovsmirnova71@mail.ruМаркинаА. Н.MarkinaA. N.

К.м.н., старший научный сотрудник лаборатории клинической патофизиологии 

г. Красноярск

PhD (Medicine), Senior Research Associate, Laboratory of Clinical Pathophysiology

Krasnoyarsk

angel.lor.ru@mail.ruПариловаО. В.ParilovaO. V.

К.м.н., ведущий научный сотрудник лаборатории клинической патофизиологии

г. Красноярск

PhD (Medicine), Leading Research Associate, Laboratory of Clinical Pathophysiology

Krasnoyarsk

 

olga_lor@mail.ruНаучно-исследовательский институт медицинских проблем Севера – обособленное подразделение ФГБНУ «Федеральный исследовательский центр “Красноярский научный центр Сибирского отделения Российской академии наук”»РоссияResearch Institute of Medical Problems of the North, Krasnoyarsk Research Center, Siberian Branch, Russian Academy of SciencesRussian Federation2024130920232612736Copyright © Смирнова О.В., Маркина А.Н., Парилова О.В., 20242024Смирнова О.В., Маркина А.Н., Парилова О.В.Smirnova O.V., Markina A.N., Parilova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/2634

Хронический риносинусит (ХРС) – заболевание, обусловленное воспалением придаточных пазух носа и ее слизистой оболочки с длительностью симптомов заболевания более 4 недель непрерывно. Целью нашего исследования явилось изучение основных патофизиологических особенностей хронических IgЕ-опосредованных риносинуситов бактериальной этиологии по данным публикаций в Российской Федерации и в мире. Был произведен анализ англо- и русскоязычных публикаций с использованием следующих баз данных: PubMed, MedLine, Web of Science, Russian Science Citation Index, Springer, Scopus, Scientific Research, Google Scholar, Crossref, eLibrary. Были изучены эпидемиологические особенности ХРС в Российской Федерации, бактериальные возбудители и патофизиологическая характеристика ХРС. За последние 20 лет наблюдается увеличение распространенности ХРС в 2 раза. С ростом возрастного интервала повышается и распространенность заболевания. Хронический риносинусит занимает первое место среди всех хронических заболеваний в оториноларингологии Аллергический ринит, астма, бронхоэктатическая болезнь, иммунодефициты, муковисцидоз, первичная цилиарная дискинезия и аутоиммунные заболевания связаны с ХРС. Наиболее часто бактериальными возбудителями являются S. aureus, Staphylococcus epidermidis и Propionibacterium acnes, Prevotella, Streptococcus и Veillonella, а из грамотрицательных бактерий такие, как Pseudomonas aeruginosa (P. aeruginosa), Proteus mirabilis и Klebsiella pneumoniae. Золотистый стафилококк (S. aureus) участвует в патогенезе носовых полипов. Колонизирующие бактерии могут способствовать патогенезу ХРС посредством образования биопленок. Изменение синоназального микробиома также может способствовать развитию ХРС. В патогенезе ХРС играет значимую роль ассоциация мутаций генов CRS и CFTR. Предложена «гипотеза иммунного барьера» как причины ХРС. Снижение экспрессии SPINK5, нарушение передачи сигналов STAT3, полиморфизм рецептора горького вкуса T2R38, были выявлены в патогенезе ХРС. Ген T2R38 стимулирует эпителиальные клетки к выработке закиси азота с бактерицидным действием, способствует мукоцилиарной элиминации патогенов и профилактике инфекций верхних дыхательных путей, полиморфизм данного гена предрасполагает больных к грамотрицательным инфекционным заболеваниям, поэтому является фактором риска развития ХРС. Кроме этого дефицит антител является наиболее распространенным первичным иммунодефицитом, связанным с ХРС.

Таким образом, патогенез хронических IgЕ-опосредованных риносинуситов бактериальной этиологии связан с дефектами врожденного иммунитета и мукоцилиарного клиренса, влиянием синоназального микробиома, аллергии и генетических факторов. Комплексная оценка перечисленных факторов необходима для разработки новых профилактических и терапевтических вариантов коррекции ХРС.

Chronic rhinosinusitis (CRS) is a disease caused by inflammation of the paranasal sinuses and its mucous membrane lasting for more than 4 weeks continuously. The aim of our study was to examine the main pathophysiological features of chronic IgE-mediated rhinosinusitis of bacterial etiology according to publications in the Russian Federation and in the world. A search was made through English- and Russian-language literature sources using the following databases: PubMed, MedLine, Web of Science, Russian Science Citation Index, Springer, Scopus, Scientific Research, Google Scholar, Crossref, eLibrary. The epidemiological features of CRS in the Russian Federation, bacterial pathogens and pathophysiological characteristics of CRS were analyzed. A 2-fold increase in the prevalence of CRS was registered over the past 20 years. Prevalence of the disease increases at longer age ranges. Chronic rhinosinusitis ranks first among all chronic diseases in the field of otorhinolaryngology. Allergic rhinitis, asthma, bronchiectasia, immunodeficiencies, cystic fibrosis, primary ciliary dyskinesia and autoimmune diseases are associated with CRS. The most common bacterial pathogens are S. aureus, Staphylococcus epidermidis and Propionibacterium acnes, Prevotella, Streptococcus and Veillonella, and some Gram-negative bacteria, e.g., Pseudomonas aeruginosa (P. aeruginosa), Proteus mirabilis and Klebsiella pneumoniae. Staphylococcus aureus (S. aureus) is involved in pathogenesis of nasal polyps. The colonizing bacteria may contribute to pathogenesis of CRS through the formation of biofilms. Alterations in the sino-nasal microbiome may also contribute to the development of CRS. An association of the CRS and CFTR gene mutations plays a significant role in the pathogenesis of chronic rhinosinusitis. An “immune barrier hypothesis” has been proposed as potential mechanism of CRS. Reduced expression of SPINK5, impaired STAT3 signaling, and T2R38 bitter taste receptor polymorphism have been identified in the pathogenesis of CRS. The T2R38 gene stimulates epithelial cells to produce nitrous oxide with a bactericidal effect, promotes mucociliary elimination of pathogens and prevention of upper respiratory tract infections, the polymorphism of this gene predisposes patients to gram-negative infectious diseases, and therefore is a risk factor for the development of CRS. In addition, antibody deficiency is the most common primary immunodeficiency associated with CRS.

Hence, the pathogenesis of chronic IgE-mediated rhinosinusitis of bacterial etiology is associated with defects in innate immunity and mucociliary clearance, influence of the sinonasal microbiome, allergies, and genetic factors. A comprehensive assessment of these factors is necessary for the development of new preventive and therapeutic options for the correction of CRS.

хронический риносинуситполипысиноназальный микробиомбиологические пленкигенетические факторыиммунитетchronic rhinosinusitispolypssinonasal microbiomebiological filmsgenetic factorsimmunityReferencesИванченко О.А., Лопатин А.С. Эпидемиология хронического риносинусита: результаты многоцентрового опроса взрослой популяции // Российская ринология, 2013. Т. 21, № 3. С. 16-19.Ivanchenko O.A., Lopatin A.S. Epidemiology of chronic rhinosinusitis: results of a multicentre survey of the adult population. Russian rhinology. 2013;21(3):16-19.Кривопалов А.А. Определения, классификации, этиология и эпидемиология риносинуситов (обзор литературы) // Российская ринология.2016. Т. 24, № 2. С. 39-45.Krivopalov A.A. Definitions, classifications, etiology and epidemiology of rhinosinusitis (literature review). Russian Rhinology.2016;24(2):39-45.Лопатин А.С., Гамов В.П. Острый и хронический риносинусит. М.: МИА, 2011. 76 с.Lopatin A.S., Gamov V.P. Acute and chronic rhinosinusitis. M.: MIA; 2011, 76 p.Туровский А.Б. Хронический синусит. Новые возможности медикаментозной терапии // Поликлиника, 2013. Т. 2, № 1. С. 66-68.Turovsky A.B. Chronic sinusitis. New possibilities of drug therapy. Polyclinic. 2013;(2-1):66-68.Янов Ю.К., Рязанцев С.В., Страчунский Л.С., Стецюк О.У., Каманин Е.И., Тарасов А.А., Отвагин И.В., Крюков А.И., Богомильский М.Р. Практические рекомендации по антибактериальной терапии синусита. Пособие для врачей // Клиническая микробиология и антимикробная химиотерапия, 2003. Т. 5, № 2. С. 167-174.Yanov Yu.K., Ryazantsev S.V., Strachunsky L.S., Stetsyuk O.U., Kamanin E.I., Tarasov A.A., Otvagin I.V., Kryukov A.I., Bogomilsky M. .R. Practical recommendations for antibiotic therapy of sinusitis. A guide for doctors. Clinical microbiology and antimicrobial chemotherapy. 2003;5(2):167-174.Abreu N.A., Nagalingam N.A., Song Y., Roediger F.C., Pletcher S.D., Goldberg A.N., Lynch S.V. Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis. Sci. Transl. Med., 2012, Vol. 4, 151ra124. doi: 10.1126/scitranslmed.3003783Abreu NA, Nagalingam NA, Song Y, Roediger FC, Pletcher SD, Goldberg AN, et al. Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis. Sci Transl Med 2012;4:151ra124Adappa N.D., Zhang Z., Palmer J.N., Kennedy D.W., Doghramji L., Lysenko A., Reed D.R., Scott T., Zhao N.W., D. Owens BS, Robert J. Lee PhD, Noam A. Cohen MD. The bitter taste receptor T2R38 is an independent risk factor for chronic rhinosinusitis requiring sinus surgery. Int. Forum Allergy Rhinol., 2014, Vol. 4, pp. 3-7.Adappa ND, Zhang Z, Palmer JN, Kennedy DW, Doghramji L, Lysenko A, et al. The bitter taste receptor T2R38 is an independent risk factor for chronic rhinosinusitis requiring sinus surgery. Int Forum Allergy Rhinol 2014;4:3-7.Akdis C.A., Bachert C., Cingi C., Dykewicz M.S., Hellings P.W., Naclerio R.M., Schleimer R.P., Ledford D. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J. Allergy Clin. Immunol, 2013, Vol. 131, pp. 1479-1490.Akdis CA, Bachert C, Cingi C, Dykewicz MS, Hellings PW, Naclerio RM, et al. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2013;131:1479-90.Bachert C., Gevaert P., Holtappels G., Johansson S.G., van Cauwenberge P. Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J. Allergy Clin. Immunol., 2001, Vol. 107, pp. 607-614.Bachert C, Gevaert P, Holtappels G, Johansson SG, van Cauwenberge P. Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J Allergy Clin Immunol 2001;107:607-14.Bhattacharyya N., Fried M.P. The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope, 2003, Vol. 113, pp. 125-129.Bhattacharyya N, Fried MP. The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope 2003;113:125-9.Bhattacharyya N. Bacterial infection in chronic rhinosinusitis: a controlled paired analysis. Am. J. Rhinol., 2005, Vol. 19, pp. 544-548.Bhattacharyya N. Bacterial infection in chronic rhinosinusitis: a controlled paired analysis. Am J Rhinol 2005;19:544-8.Boase S., Foreman A., Cleland E., Tan L., Melton-Kreft R., Pant H., Z Hu F., Ehrlich G.D., Wormald P.J. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect. Dis., 2013, Vol. 13, 210. doi: 10.1186/1471-2334-13-210.Boase S, Foreman A, Cleland E, Tan L, Melton-Kreft R, Pant H, et al. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 2013;13:210.Bonilla F.A., Khan D.A., Ballas Z.K., Chinen J., Frank M.M., Hsu J.T., Keller M., Kobrynski L.J., Komarow H.D., Mazer B., Nelson Jr R.P., Orange J.S, Routes J.M., Shearer W.T., Sorensen R.U., Verbsky J.W., Bernstein D.I., BlessingMoore J., Lang D., Nicklas R.A., Oppenheimer J., Portnoy J.M., Randolph C.R., Schuller D., Spector S.L., Tilles S., Wallace D. Practice parameter for the diagnosis and management of primary immunodeficiency. J. Allergy Clin. Immunol., 2015, Vol. 136, pp. 1186-1205.e78.Bonilla FA, Khan DA, Ballas ZK, Chinen J, Frank MM, Hsu JT, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol 2015;136:1186-1205.e78.Brinke A., Sterk P.J., Masclee A.M., Spinhoven P., Schmidt J.T., Zwinderman A.H., Rabe K.F., Bel E.H. Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur. Respir. J., 2005, Vol. 26, pp. 812-818.Brinke A, Sterk PJ, Masclee AA, Spinhoven P, Schmidt JT, Zwinderman AH, et al. Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J 2005;26:812-8.Cohen N.A., Widelitz J.S., Chiu A.G., Palmer J.N., Kennedy D.W. Familial aggregation of sinonasal polyps correlates with severity of disease. Otolaryngol. Head Neck Surg., 2006, Vol. 134, pp. 601-604.Cohen NA, Widelitz JS, Chiu AG, Palmer JN, Kennedy DW. Familial aggregation of sinonasal polyps correlates with severity of disease. Otolaryngol Head Neck Surg 2006;134:601-4.Costerton J.W., Stewart P.S., Greenberg E.P. Bacterial biofilms: a common cause of persistent infections. Science, 1999, Vol. 284, pp. 1318-1322.Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science 1999;284:1318-22.Fokkens W.J., Lund V.J., Mullol J., Bachert C., Alobid I., Baroody F., Cohen N., Cervin A., Douglas R., Gevaert P., Georgalas C., Goossens H., Harvey R., Hellings P., Hopkins C., Jones N., Joos G., Kalogjera L., Kern B., Kowalski M., Price D., Riechelmann H., Schlosser R., Senior B., Thomas M., Toskala E., Voegels R., Wang D.Y., Wormald P.J. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol. Suppl., 2012, Vol. 23, pp. 1-298.Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 2012;3:1-298.Fried A.J., Bonilla F.A. Pathogenesis, diagnosis, and management of primary antibody deficiencies and infections. Clin. Microbiol. Rev., 2009, Vol. 22, pp. 396-414.Fried AJ, Bonilla FA. Pathogenesis, diagnosis, and management of primary antibody deficiencies and infections. Clin Microbiol Rev 2009;22:396-414Guilemany J.M., Angrill J., Alobid I., Centellas S., Pujols L., Bartra J., Bernal-Sprekelsen M., Valero A., Picado C., Mullol J. United airways again: high prevalence of rhinosinusitis and nasal polyps in bronchiectasis. Allergy, 2009, Vol. 64, pp. 790-797.Guilemany JM, Angrill J, Alobid I, Centellas S, Pujols L, Bartra J, et al. United airways again: high prevalence of rhinosinusitis and nasal polyps in bronchiectasis. Allergy 2009;64:790-7.Harvey R., Hannan S.A., Badia L., Scadding G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst. Rev., 2007, no. 3, CD006394. doi: 10.1002/14651858.CD006394.pub2.Harvey R, Hannan SA, Badia L, Scadding G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev 2007;(3): CD006394.Hsu J., Avila P.C., Kern R.C., Hayes M.G., Schleimer R.P., Pinto J.M. Genetics of chronic rhinosinusitis: state of the field and directions forward. J. Allergy Clin. Immunol., 2013, Vol. 131, pp. 977-993.Hsu J, Avila PC, Kern RC, Hayes MG, Schleimer RP, Pinto JM. Genetics of chronic rhinosinusitis: state of the field and directions forward. J Allergy Clin Immunol 2013;131:977-93.Kashani S., Carr T.F., Grammer L.C., Schleimer R.P., Hulse K.E., Kato A., Kern R.C., Conley D.B., Chandra R.K., Tan B.K., Peters A.T. Clinical characteristics of adults with chronic rhinosinusitis and specific antibody deficiency. J. Allergy Clin. Immunol. Pract., 2015, Vol. 3, pp. 236-242.Kashani S, Carr TF, Grammer LC, Schleimer RP, Hulse KE, Kato A, et al. Clinical characteristics of adults with chronic rhinosinusitis and specific antibody deficiency. JAllergy Clin Immunol Pract 2015;3:236-42.Khalid A.N., Mace J.C., Smith T.L. Outcomes of sinus surgery in ambulatory patients with immune dysfunction. Am. J. Rhinol. Allergy, 2010, Vol. 24, pp. 230-233.Khalid AN, Mace JC, Smith TL. Outcomes of sinus surgery in ambulatory patients with immune dysfunction. Am J Rhinol Allergy 2010;24:230-3.Lal D., Scianna J.M., Stankiewicz J.A. Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am. J. Rhinol. Allergy, 2009, Vol. 23, pp. 396-400.Lal D, Scianna JM, Stankiewicz JA. Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am J Rhinol Allergy 2009;23: 396-400.Lee R.J., Cohen N.A. Role of the bitter taste receptor T2R38 in upper respiratory infection and chronic rhinosinusitis. Curr. Opin. Allergy Clin. Immunol., 2015, Vol. 15, pp. 14-20.Lee RJ, Cohen NA. Role of the bitter taste receptor T2R38 in upper respiratory infection and chronic rhinosinusitis. Curr Opin Allergy Clin Immunol 2015;15:14-20.Lim M., Citardi M.J., Leong J.L. Topical antimicrobials in the management of chronic rhinosinusitis: a systematic review. Am. J. Rhinol., 2008, Vol. 22, pp. 381-389.Lim M, Citardi MJ, Leong JL. Topical antimicrobials in the management of chronic rhinosinusitis: a systematic review. Am J Rhinol 2008;22:381-9.Mfuna-Endam L., Zhang Y., Desrosiers M.Y. Genetics of rhinosinusitis. Curr. Allergy Asthma Rep., 2011, Vol. 11, pp. 236-246.Mfuna-Endam L, Zhang Y, Desrosiers MY. Genetics of rhinosinusitis. Curr Allergy Asthma Rep 2011;11:236-46.Min J.Y., Tan B.K. Risk factors for chronic rhinosinusitis. Curr. Opin. Allergy Clin. Immunol., 2015, Vol. 15, pp. 1-13.Min JY, Tan BK. Risk factors for chronic rhinosinusitis. Curr Opin Allergy Clin Immunol 2015;15:1-13.Ocampo C.J., Grammer L.C. Chronic rhinosinusitis. J. Allergy Clin. Immunol. Pract., 2013, Vol. 1, pp. 205-211.Ocampo CJ, Grammer LC. Chronic rhinosinusitis. J Allergy Clin Immunol Pract 2013;1:205-11. quiz 12-3.Ocampo C.J., Peters A.T. Antibody deficiency in chronic rhinosinusitis: epidemiology and burden of illness. Am. J. Rhinol. Allergy, 2013, Vol. 27, pp. 34-38.Ocampo CJ, Peters AT. Antibody deficiency in chronic rhinosinusitis: epidemiology and burden of illness. Am J Rhinol Allergy 2013;27:34-8.Peters A.T., Kato A., Zhang N., Conley D.B., Suh L., Tancowny B., Carter D., Carr T., Radtke M., Hulse K.E., Seshadri S., Chandra R., Grammer L.C., Harris K.E., Kern R., Schleimer R.P. Evidence for altered activity of the IL-6 pathway in chronic rhinosinusitis with nasal polyps. J. Allergy Clin. Immunol., 2010, Vol. 125, pp. 397-403.e10.Peters AT, Kato A, Zhang N, Conley DB, Suh L, Tancowny B, et al. Evidence for altered activity of the IL-6 pathway in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol 2010;125:397-403.e10.Peters A.T., Spector S., Hsu J., Hamilos D.L., Baroody F.M., Chandra R.K., Grammer L.C., Kennedy D.W., Cohen N.A., Kaliner M.A., Wald E.R., Karagianis A., Slavin R.G. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann. Allergy Asthma Immunol., 2014, Vol. 113, pp. 347-385.Peters AT, Spector S, Hsu J, Hamilos DL, Baroody FM, Chandra RK, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol 2014;113:347-85.Piromchai P., Thanaviratananich S., Laopaiboon M. Systemic antibiotics for chronic rhinosinusitis without nasal polyps in adults. Cochrane Database Syst. Rev., 2011, no. 5, CD008233. doi: 10.1002/14651858.CD008233. pub2.Piromchai P, Thanaviratananich S, Laopaiboon M. Systemic antibiotics for chronic rhinosinusitis without nasal polyps in adults. Cochrane Database Syst Rev 2011;(5):CD008233.Quinti I., Soresina A., Spadaro G., Martino S., Donnanno S., Agostini C., Claudio P., Franco D., Pesce A.M., Borghese F., Guerra A., Rondelli R., Plebani A. Long-term follow-up and outcome of a large cohort of patients with common variable immunodeficiency. J. Clin. Immunol., 2007, Vol. 27, pp. 308-316.Quinti I, Soresina A, Spadaro G, Martino S, Donnanno S, Agostini C, et al. Long-term follow-up and outcome of a large cohort of patients with common variable immunodeficiency. J Clin Immunol 2007;27:308-16.Ragab S., Scadding G.K., Lund V.J., Saleh H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur. Respir. J., 2006, Vol. 28, pp. 68-74.Ragab S, Scadding GK, Lund VJ, Saleh H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur Respir J 2006;28:68-74.Ramakrishnan V.R., Hauser L.J., Feazel L.M., Ir D., Robertson C.E., Frank D.N. Sinus microbiota varies among chronic rhinosinusitis phenotypes and predicts surgical outcome. J. Allergy Clin. Immunol., 2015, Vol. 136, pp. 334-342.e1.Ramakrishnan VR, Hauser LJ, Feazel LM, Ir D, Robertson CE, Frank DN. Sinus microbiota varies among chronic rhinosinusitis phenotypes and predicts surgical outcome. J Allergy Clin Immunol 2015;136:334-342.e1.Richer S.L., Truong-Tran A.Q., Conley D.B., Carter R., Vermylen D., Grammer L.C., Peters A.T., Chandra R.K., Harris K.E., Kern R.C., Schleimer R.P. Epithelial genes in chronic rhinosinusitis with and without nasal polyps. Am. J. Rhinol., 2008, Vol. 22, pp. 228-234.Richer SL, Truong-Tran AQ, Conley DB, Carter R, Vermylen D, Grammer LC, et al. Epithelial genes in chronic rhinosinusitis with and without nasal polyps. Am J Rhinol 2008;22:228-34.Rosenfeld R.M., Piccirillo J.F., Chandrasekhar S.S., Brook I., Kumar K.A., Kramper M., Orlandi R.R., Palmer J.N., Patel Z.M., Peters A., Walsh S.A., Corrigan M.D. Clinical practice guideline (update): adult sinusitis. Otolaryngol. Head Neck Surg., 2015, Vol. 152, pp. S1-S39.Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015;152(Suppl):S1-39.Rudmik L., Smith T.L., Schlosser R.J., Hwang P.H., Mace J.C., Soler Z.M. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope, 2014, Vol. 124, pp. 2007-2012.Rudmik L, Smith TL, Schlosser RJ, Hwang PH, Mace JC, Soler ZM. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope 2014;124:2007-12.Schwitzguebel A.J., Jandus P., Lacroix J.S., Seebach J.D., Harr T. Immunoglobulin deficiency in patients with chronic rhinosinusitis: systematic review of the literature and meta-analysis. J. Allergy Clin. Immunol., 2015, Vol. 136, pp. 1523-1531.Schwitzguebel AJ, Jandus P, Lacroix JS, Seebach JD, Harr T. Immunoglobulin deficiency in patients with chronic rhinosinusitis: systematic review of the literature and meta-analysis. J Allergy Clin Immunol 2015;136: 1523-31.Seshadri S., Lin D.C., Rosati M., Carter R.G., Norton J.E., Suh L., Kato A., Chandra R.K., Harris K.E., Chu H.W., Peters A.T., Tan B.K., Conley D.B., Grammer L.C., Kern R.C., Schleimer R.P. Reduced expression of antimicrobial PLUNC proteins in nasal polyp tissues of patients with chronic rhinosinusitis. Allergy, 2012, Vol. 67, pp. 920-928.Seshadri S, Lin DC, Rosati M, Carter RG, Norton JE, Suh L, et al. Reduced expression of antimicrobial PLUNC proteins in nasal polyp tissues of patients with chronic rhinosinusitis. Allergy 2012;67:920-8.Singhal D., Foreman A., Jervis-Bardy J., Wormald P.J. Staphylococcus aureus biofilms: nemesis of endoscopic sinus surgery. Laryngoscope, 2011, Vol. 121, pp. 1578-1583.Singhal D, Foreman A, Jervis-Bardy J, Wormald PJ. Staphylococcus aureus biofilms: nemesis of endoscopic sinus surgery. Laryngoscope 2011;121: 1578-83.Stein M., Caplan E.S. Nosocomial sinusitis: a unique subset of sinusitis. Curr. Opin. Infect. Dis., 2005, Vol. 18, pp. 147-150.Stein M, Caplan ES. Nosocomial sinusitis: a unique subset of sinusitis. Curr Opin Infect Dis 2005;18:147-50.Stevens W.W., Lee R.J., Schleimer R.P., Cohen N.A. Chronic rhinosinusitis pathogenesis. J. Allergy Clin. Immunol., 2015, Vol. 136, pp. 1442-1453.Stevens WW, Lee RJ, Schleimer RP, Cohen NA. Chronic rhinosinusitis pathogenesis. J Allergy Clin Immunol 2015;136:1442-53.Subramanian H.N., Schechtman K.B., Hamilos D.L. A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am. J. Rhinol., 2002, Vol. 16, pp. 303-312.Subramanian HN, Schechtman KB, Hamilos DL. A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 2002;16:303-12.Thanasumpun T., Batra P.S. Endoscopically-derived bacterial cultures in chronic rhinosinusitis: a systematic review. Am. J. Otolaryngol., 2015, Vol. 36, pp. 686-691.Thanasumpun T, Batra PS. Endoscopically-derived bacterial cultures in chronic rhinosinusitis: a systematic review. Am J Otolaryngol 2015;36:686-91.Tieu D.D., Peters A.T., Carter R.G., Suh L., Conley D.B., Chandra R., Norton J., Grammer L.C., Harris K.E., Kato A., Kern R.C., Schleimer R.P. Evidence for diminished levels of epithelial psoriasin and calprotectin in chronic rhinosinusitis. J. Allergy Clin. Immunol., 2010, Vol. 125, pp. 667-675.Tieu DD, Peters AT, Carter RG, Suh L, Conley DB, Chandra R, et al. Evidence for diminished levels of epithelial psoriasin and calprotectin in chronic rhinosinusitis. J Allergy Clin Immunol 2010;125:667-75.Tripathi A., Conley D.B., Grammer L.C., Ditto A.M., Lowery M.M., Seiberling K.A., Yarnold P.A., Zeifer B., Kern R.C. Immunoglobulin E to staphylococcal and streptococcal toxins in patients with chronic sinusitis/nasal polyposis. Laryngoscope, 2004, Vol. 114, pp. 1822-1826.Tripathi A, Conley DB, Grammer LC, Ditto AM, Lowery MM, Seiberling KA, et al. Immunoglobulin E to staphylococcal and streptococcal toxins in patients with chronic sinusitis/nasal polyposis. Laryngoscope 2004;114:1822-6.Tsou Y.-A., Peng M.-T., Wu Y.-F., Lai C.-H., Lin C.-D., Tai C.-J., Tsai M.-H., Chen C.-M., Chen H.-C. Decreased PLUNC expression in nasal polyps is associated with multibacterial colonization in chronic rhinosinusitis patients. Eur. Arch. Otorhinolaryngol., 2014, Vol. 271, pp. 299-304.Tsou YA, Peng MT, Wu YF, Lai CH, Lin CD, Tai CJ, et al. Decreased PLUNC expression in nasal polyps is associated with multibacterial colonization in chronic rhinosinusitis patients. Eur Arch Otorhinolaryngol 2014;271: 299-304.van Zele T.V., Gevaert P., Holtappels G., Beule A., Wormald P.J., Mayr S., Hens G., Hellings P., Ebbens F.A., Fokkens W., Cauwenberge P.V., Bachert C. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J. Allergy Clin. Immunol., 2010, Vol. 125, pp. 1069-1076.e4.Van Zele T, Gevaert P, Holtappels G, Beule A, Wormald PJ, Mayr S, et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol 2010;125:1069-1076.e4.Vargas F., Nam Bui H., Boyer A., Bébear C.M., Lacher-Fougére S., De-Barbeyrac B.M., Salmi L.R., Traissac L., Gbikpi-Benissan G., Gruson D., Hilbert G. Transnasal puncture based on echographic sinusitis evidence in mechanically ventilated patients with suspicion of nosocomial maxillary sinusitis. Intensive Care Med., 2006, Vol. 32, pp. 858-866.Vargas F, Bui HN, Boyer A, Bebear CM, Lacher-Fougere S, De-Barbeyrac BM, et al. Transnasal puncture based on echographic sinusitis evidence in mechanically ventilated patients with suspicion of nosocomial maxillary sinusitis. Intensive Care Med 2006;32:858-66.Videler W.J., Badia L., Harvey R.J., Gane S., Georgalas C., van der Meulen F.W., Menger D.J., Lehtonen M.T., Toppila-Salmi S.K., Vento S.I., Hytönen M., Hellings P.W., Kalogjera L., Lund V.J., Scadding G., Mullol J., Fokkens W.J. Lack of efficacy of long-term, low-dose azithromycin in chronic rhinosinusitis: a randomized controlled trial. Allergy 2011, Vol. 66, pp. 1457-1468.Videler WJ, Badia L, Harvey RJ, Gane S, Georgalas C, van der Meulen FW, et al. Lack of efficacy of long-term, low-dose azithromycin in chronic rhinosinusitis: a randomized controlled trial. Allergy 2011;66:1457-68.Wallwork B., Coman W., Mackay-Sim A., Greiff L., Cervin A. A double-blind, randomized, placebocontrolled trial of macrolide in the treatment of chronic rhinosinusitis. Laryngoscope, 2006, Vol. 116, pp. 189-193.Wallwork B, Coman W, Mackay-Sim A, Greiff L, Cervin A. A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis Laryngoscope 2006;116:189-93.Wuister A.M.H., Goto N.A., Oostveen E.J., de Jong W.U., van der Valk E.S., Kaper N.M., Aarts M.C.J., Grolman W., van der Heijden G.J.M.G. Nasal endoscopy is recommended for diagnosing adults with chronic rhinosinusitis. Otolaryngol. Head Neck Surg., 2014, Vol. 150, pp. 359-364.Wuister AM, Goto NA, Oostveen EJ, de Jong WU, van der Valk ES, Kaper NM, et al. Nasal endoscopy is recommended for diagnosing adults with chronic rhinosinusitis. Otolaryngol Head Neck Surg 2014;150:359-64.

The authors declare that there are no conflicts of interest present.